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Ann Thorac Surg 1990;49:195-201
© 1990 The Society of Thoracic Surgeons
Cardiovascular and Thoracic Surgical Associates, Miami Heart Institute, Miami, Florida USA
* Address reprint requests to Dr Galbut, 1150 NW 14th St, Suite 207, Miami, FL 33136.
The internal mammary artery (IMA) is being recognized as the conduit of choice for myocardial revascularization. From January 1972 through June 1988, 1,087 patients received bilateral IMA and supplemental vein grafts. There were 917 men (84.4%) and 170 women (15.6%) with a mean age of 62.4 years (range, 29 to 84 years). Three hundred ninety-four patients (36.2%) had unstable angina, and 194 (17.8%) had left main coronary artery stenosis greater than 50%. In all, 3,741 coronary grate were performed, with a mean of 3.4 per patient. Hospital mortality was 2.7% (29 patients). Hospital complications included reoperation for bleeding, 19 patients (1.7%); sternal infection, 16 patients (1.5%); respiratory failure, 35 patients (3.2%); perioperative myocardial infarction, 22 patients (2.0%); and stroke, 20 patients (1.8%). Postoperative arteriography in 53 patients (mean postoperative time, 53.0 months) showed that 92.1% ([equation]) of the left IMA and 84.9% ([equation]) of the right IMA grafts were patent. Follow-up was completed on 1,058 hospital survivors. There were 82 late deaths (7.8%). The actuarial survival for patients discharged from the hospital was 80.0% ± 3.2% (plus or minus standard error of the mean) at 10 years and 60.0% ± 5.0% at 15 yean. At follow-up, 866 patients (90.3%) were asymptomatic and in New York Hearl Association class I and 68 (7.1%) were in class II. This longitudinal analysis demonstrates that bilateral IMA grafting has a low operative risk and provides excellent long-term functional improvement and survival.
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D. Navia, D. M. Cosgrove III, B. W. Lytle, P. C. Taylor, P. M. McCarthy, R. W. Stewart, E. R. Rosenkranz, and F. D. Loop Is the internal thoracic artery the conduit of choice to replace a stenotic vein graft? Ann. Thorac. Surg., January 1, 1994; 57(1): 40 - 44. [Abstract] [PDF]
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G.-W. He, W. H. Ryan, T. E. Acuff, R. T. Bowman, M. B. Douthit, C.-Q. Yang, and M. J. Mack Risk factors for operative mortality and sternal wound infection in bilateral internal mammary artery grafting J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 196 - 202. [Abstract] [Full Text]
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J. I. Aramendi, E. Castellanos, A. O. de Salazar, A. Onate, F. Munoz, and M. Antonana Myocardial Revascularization with the Gastroepiploic Artery Vascular and Endovascular Surgery, November 1, 1993; 27(9): 673 - 679. [Abstract] [PDF]
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G. M. Palatianos, H. Bolooki, M. D. Horowitz, M. H. Lowery, S. P. Rosenthal, S. K. C. Chandarlapaty, G. N. Sfakianakis, and G. A. Kaiser Sequential internal mammary artery grafts for coronary artery bypass Ann. Thorac. Surg., November 1, 1993; 56(5): 1136 - 1140. [Abstract] [PDF]
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J. A. M. van Son, F. Smedts, P. C. M. de Wilde, N. H. J. Pijls, L. Wong-Alcala, K. Kubat, G. Tavilla, and L. K. Lacquet Histological study of the internal mammary artery with emphasis on its suitability as a coronary artery bypass graft Ann. Thorac. Surg., January 1, 1993; 55(1): 106 - 113. [Abstract] [PDF]
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J. M. Cunningham, M. A. Gharavi, R. Fardin, and R. A. Meek Considerations in the skeletonization technique of internal thoracic artery dissection Ann. Thorac. Surg., November 1, 1992; 54(5): 947 - 950. [Abstract] [PDF]
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M. Carrier, J. Gregoire, F. Tronc, R. Cartier, Y. Leclerc, and L.-C. Pelletier Effect of internal mammary artery dissection on sternal vascularization Ann. Thorac. Surg., January 1, 1992; 53(1): 115 - 119. [Abstract] [PDF]
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D. L. Galbut, E. A. Traad, M. J. Dorman, P. L. DeWitt, P. B. Larsen, P. A. Kurlansky, J. H. Button, J. M. Ally, and T. O. Gentsch Bilateral internal mammary artery grafts in reoperative and primary coronary bypass surgery Ann. Thorac. Surg., July 1, 1991; 52(1): 20 - 28. [Abstract] [PDF]
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N. T. Kouchoukos, T. H. Wareing, S. F. Murphy, C. Pelate, and W. G. Marshall Jr Risks of bilateral internal mammary artery bypass grafting Ann. Thorac. Surg., February 1, 1990; 49(2): 210 - 219. [Abstract] [PDF]
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